Det danske Fredsakademi
Kronologi over fredssagen og international politik 4. december 2005 / Time Line December 4, 2005
Version 3.53. December 2005, 5. December 2005
12/04/2005
Trauma Surgeon Deals With Horrors Of IEDs Injuries
By Tom Philpott, Special to Stars and Stripes
Mideast Stars and Stripes
Before he returned to active duty last year, Army Reserve Maj.
Donald W. Robinson was a civilian trauma surgeon at Cooper Hospital
in Camden, N.J., a city known as the "murder capital" of
America.
Nothing Robinson saw in Camden, however, came close to the horrors
he and his surgical teams with the 86th Combat Support Hospital
faced in Baghdad, from last December through July this year.
"I expected to see a lot of penetrating trauma because those were
the reports coming out of Iraq," Robinson said in a phone interview
from his current assignment at Fort Benning, Ga. "When I got there
I was taken aback. This was penetrating trauma to the nth degree.
It was massive. The tissue destruction was like nothing I'd ever
seen before."
Robinson, 43, said he hasn't talked with surgeons from the Vietnam
War but he has read about the battlefield injuries they treated. He
believes the wounds being suffered daily in Iraq, mostly from large
improvised explosive devices, are unlike anything seen before in a
war.
"It's just hard to explain the amount of destruction with an IED,"
Robinson said. "Imagine shards of metal going everywhere... Add the
percussion from the blast. Then put someone inside a Bradley
fighting vehicle and add fire to it and burning flesh. A person
inhales and [suffers] inhalation injury.. They didn't have that in
Vietnam, not all that together."
Maj. Gen. George Weightman, who oversees Army medical training,
said the military has come to recognize that medical personnel in
Iraq who treat severe wounds are high risk for post-traumatic
stress disorder.
"We refer to that as compassion fatigue," Weightman said. "How many
really banged-up, mangled bodies can you take care of before, all
of a sudden, you just get numb or can't handle it anymore?"
Robinson and the 86th were assigned to Ibn Sina Hospital, a modern
facility built for Saddam Hussein's army. On his first day, still
feeling jet lag, he walked into the emergency room at 9 a.m., as
five trauma patients were arriving. It was his first experience
with IED victims.
"In all honesty, it just looked like destruction," said Robinson.
"Blood everywhere. People were screaming. It was chaos."
Robinson, chief of surgical and critical care for the 86th, and a
doctor who was showing him around, each took a patient into
surgery.
"That day seemed like it never ended because, after that, another
patient came in and then another and another. The next thing I knew
it was 12 o'clock at night.. I went to sleep on the floor.. Woke up
the next morning about six o'clock and it was the same thing, and
just kept going."
He operated on almost 400 patients over the next seven months. The
key to trauma surgery in that environment, he said, is discipline
and training. And teamwork, he said, was never more critical than
in Iraq.
"I understood it, having worked in a trauma center, but I really
understand it now. And it has to be the whole team, firing on all
cylinders. When you do that anesthesia to techs to nurses
you save lives."
Robinson said 70 percent of his patients were IED victims. Eighty
percent were Iraqis, military and civilian. All got the same
quality of care, he said, but emotionally it was hard not to react
to severely injured Americans.
"It hurt me to see my Marines and my soldiers get hurt," said
Robinson, former surgeon for 7th Special Forces Group. "Sometimes I
had a hard time with it. I didn't punch too many walls but . I
think I punched a wall twice. You get frustrated."
Before surgery, Robinson said, he would reassure every patient,
kneeling down to "whisper in their ear, 'Look, my name is Dr.
Robinson. I'm your surgeon. We're going to get through this. Don't
worry. I gotcha.'"
When a patient died, Robinson said, his staff knew to leave him
alone. He would find a quiet place, sometimes the hospital roof,
and say a prayer.
"I wished I could have called that person's mom or dad to say, 'You
know, I'm the one who took care of your son, and I want you to know
that we did everything possible to save his life.' I wish I could
have done that for every single soldier or Marine or airman."
Robinson frequently counseled young medics and nurses, worried
about how they were coping with all the trauma cases. In Iraq, he
was too busy to weigh the effect on himself. At home, however, he
had difficulty sleeping. For two weeks he slept on the floor so as
not to disturb his wife, Shari. He had nightmares, recalling the
many amputations he performed.
Rather than dreams of helping patients, his were filled with the
horror of their injuries. "It's almost like you know you can help
the person, but it's just the intensity of what this person has
gone through, and will have to live with. I would go to sleep and I
would see that."
In our hourlong interview, Robinson never mentioned his phone calls
home to Shari "just to unload," as she described it. During those
calls, Shari said, Don was particularly troubled by the many
children he treated who had been burned or had lost limbs. The Iraq
experience made him miss his own children deeply, son Kimani, age
11, and daughter Karina, age 3.
Robinson, who soon will be training other trauma surgeons for Iraq,
thought about getting counseling but he now feels he's doing OK,
and able to talk things out with Shari and his pastor, "a good
support system.."
Before rejoining the Army, the Robinson knew his pay would fall by
a third and that Iraq would be dangerous. So Shari would ask: Why
do it?
"Simple," Robinson said. "I think I can save lives. If it was my
son over there, I would want me taking care of him. That's the
bottom line."
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